Stanislaus County makes decision on health service cuts after hearing from critics

Stanislaus County leaders gave approval Tuesday to turning over two county health clinics to another provider, after speakers criticized the board for not communicating the proposals to the west Modesto community.

Merced-based Golden Valley Health Centers will take over operation of the county’s Paradise Medical Office in west Modesto, as of July 1, and also will assume operation of a county specialty clinic on McHenry Avenue offering orthopedic, neuro- and general surgery, wound care and physical rehab services.

In another major change, physicians with Golden Valley will take over supervision of family practice residents, a move that’s deemed necessary to maintain a residency program that has brought doctors to the Modesto area for years. The county will remain a partner with Doctors Medical Center, Memorial hospital and Golden Valley in the Valley Consortium for Medical Education, which operates the residency program.

The county will also eliminate obstetrical care at the McHenry Medical Office on Woodrow Avenue, prompting a veteran doctor to warn that patients with high-risk pregnancies will need to be carefully transitioned to care at a Golden Valley site.

The cuts will leave the county with two remaining health clinics for the poor — McHenry Medical Office and the Family and Pediatric Health Center on Scenic Drive. From 65 to 70 union-represented county health workers and 25 part-timers will be relocated to shore up staffing at the county’s two remaining clinics.

Perfecto Munoz, chief executive officer of the West Modesto Community Collaborative, said he didn’t hear about the proposals until a day before a March 21 community meeting and it was too late to get people to attend. He was able to spread the word for community members to attend a second meeting in April.

Munoz said townhall meetings should be held in the community so people know what’s happening. An oversight committee with community representatives should monitor the transition, he said.

Mary Kate Johnson, a patient of the Paradise clinic, expressed concern she won’t get the same quality of care.

Johnson said she knows a person who’s a patient of the Golden Valley system and struggles with health problems. She said she took her daughter to a Golden Valley clinic some years ago and it wasn’t a good experience. “The doctors barely had any time to talk with you and there was no consistency in the kind of care she received,” Johnson said. “Has that improved?”

County Supervisor Vito Chiesa said Golden Valley is a stronger organization than it was five years ago.

Another patient, who didn’t give her name at the podium, said the county’s wound care clinic in the black-glass building on McHenry is the best and accepts walk-ins. “The doctor’s dedication to patient care goes beyond the call of duty,” she said. “His approach to patient care is exemplary and he teaches the resident (physicians) wound care by hands-on experience.”

Brian Bigelow, an obstetrician in local practice since 1977, mentioned eight obstetrical providers who retired, died or left the community, none of whom were replaced, leaving a critical shortage.

Asked to return to teaching resident physicians, Bigelow said the high-risk pregnancy clinics at McHenry Medical Office are overbooked, with 20 patients a week needing electronic fetal monitoring. “My concern, in addition to the manpower shortage, is getting these patients at (McHenry Medical Office) over to Golden Valley by July 1,” Bigelow said. “We don’t want it to happen so quickly that it’s not done well and it falls apart.”

David Quackenbush, who soon takes over as chief executive officer of Golden Valley, said the organization will keep the specialty clinic on McHenry Avenue at that same location. He said the family practice services, a geriatric clinic, LGBTQ health services and the other medical services will continue at the Paradise clinic.

Urgent care hours will remain at the Paradise center, and the county will add urgent care to one of its clinics. County patients with difficult pregnancies will receive care at a Golden Valley site across from Doctors Medical Center, Quackenbush said.

Quackenbush welcomed representatives from Modesto and Stanislaus County to serve on Golden Valley’s patient advisory committee.

Patients need information, transportation

Noe Paramo, legislative advocate for California Rural Legal Assistance Foundation, said culturally appropriate information and transportation assistance will be important for patients during the transition.

He suggested a community oversight committee and bilingual patient navigators to monitor the transition and ensure good outcomes.

Supervisor Channce Condit said the county didn’t have much choice in the matter, because of the need to preserve the program for training resident physicians.

Dr. Eric Ramos, representing VCME, said Golden Valley can supply an adequate number of doctors for training the resident physicians and that will put the program in the good graces of an accreditation council.

Ramos graduated from the Stanislaus family practice residency program in 1992 and was in private practice in Modesto for 22 years. About 30% of the program graduates have stayed in the area to practice medicine.

“Our goal is creating a pipeline of physicians who are going to stay in the community,” Ramos said.